Christopher M. Shaari, MD

Products And Services

• Endoscopic Sinus Surgery

  Endoscopic sinus surgery, also known as sinoscopy, is a minimally invasive surgical procedure used to remove blockages in the sinuses for recurring sinus infections. During the procedure, a thin lighted tube with a camera on the end is inserted into the nose to let the doctor visually examine the area. Tiny surgical instruments are then inserted to remove the obstructive tissues. Endoscopic sinus surgery does not require any incision, as the whole procedure is performed through the nostrils. Most procedures are performed on an outpatient basis and patients can go home the same day. Most patients experience a major relief in symptoms such as facial pain and swelling, difficulty breathing and headaches. Aside from sinus surgery, endoscopic sinus surgery can also treat a deviated septum, polyps or tumors.

  Link: Endoscopic Sinus Surgery

• Deviated Septum

  Septoplasty is a surgical procedure to correct defects or deformities of the septum, the partition between the two nostrils. Commonly, the procedure is performed to correct a deviated septum. While a small deviation of the septum is commonplace, if the condition is more severe it may impede airflow through the nostrils. This may cause difficulty with nasal breathing and poor nasal drainage from the sinuses, both of which are problematic. During a septoplasty, the surgeon straightens the septum and repositions it to the center of the nose. The procedure may involve removing a small part of the septum itself. In adults, it is composed of both cartilage and bone. The function of the nasal septum is to support the mucous membranes of the nose and to regulate air flow. A number of medical conditions may indicate a need for the procedure including nasal air passage obstruction, a deviated septum, tumors, chronic, uncontrolled nosebleeds or the presence of polyps. A septoplasty may also be performed in conjunction with a rhinoplasty in order to ensure that the reshaping of the nose does not result in a reduction of the amount of breathing space or in conjunction with sinus surgery to assist in post-surgical drainage. Patients who have had a septoplasty can usually return home the same day or the morning after surgery. Risks or complications are relatively rare. During recovery, patients may experience bleeding, swelling, bruising, or discoloration.

  Link: Deviated Septum

• Balloon Sinuplasty

  Balloon sinuplasty is an FDA-approved, advanced treatment option for relieving the symptoms of chronic sinusitis. It is successful in an overwhelming percentage of patients, and is considered a safe and effective treatment. Reasons For Balloon Sinuplasty Chronic sinusitis, an extremely common ailment, affects millions of people each year. Because the sinuses are hollows behind the bones of the upper face, they may become blocked by mucus, which may be a result of allergy or respiratory illness. Once they become blocked, it is easy for them to become infected. Sinusitis may be temporary and can be treated successfully with antibiotics, decongestants or steroid nasal sprays. If it becomes chronic, however, there may be a structural problem in the nose or sinuses. In those cases, a balloon sinuplasty may be recommended. The symptoms of sinusitis are uncomfortable and unpleasant, interfering with a patient’s quality of life. Symptoms of sinusitis may include: Thick, perpetual nasal secretion Headache Fatigue Tooth pain Difficulty breathing Discharge of green or yellow mucus Loss of sense of smell or taste Pain, pressure and congestion in the upper face Balloon sinuplasty is a safe, efficient, effective and, usually, long-lasting means of clearing the sinuses and restoring a patient’s health and well-being. Balloon Sinuplasty Procedure A balloon sinuplasty is a minimally invasive endoscopic procedure during which a thin balloon catheter is inserted into the nose. The balloon is gradually inflated to relieve blockages and widen the sinus pathways. A sinus-illumination system with laser-tipped guides keeps the area well-lit so that the surgeon can see the site accurately. By gently reconfiguring the structure of the bones in the nose, the catheter restores normal sinus drainage, and keeps post-operative pain and bleeding to a minimum. After the opening of the affected sinus is cleared, the balloon is deflated and removed, but the sinus remains open. Another catheter, called an irrigation catheter, is then inserted to cleanse the sinus with a saline solution. A balloon sinuplasty may be performed in a hospital, ambulatory-surgery setting or doctor’s office. Usually, the procedure is performed under general anesthesia but, in some cases, may be performed under local anesthetic. Typically, the procedure takes about 3 hours, which includes recovery time, and patients can return home shortly thereafter. Although balloon sinuplasty is a relatively new procedure, it has a very high rate of success. The great majority of patients experience relief from their symptoms soon after surgery. So far, studies show that most patients report continued sinus health for up to 2 years after the procedure. Benefits Of Balloon Sinuplasty Unlike traditional sinus surgery, balloon sinuplasty does not require incisions, or any removal of bone or tissue, although, in certain cases, it may be used in conjunction with traditional surgery. Balloon sinuplasty has many advantages over traditional procedures. Its benefits may include: Absence of surgical incisions Lack of serious complications Shorter recovery time Reduced bleeding Although balloon sinuplasty is an effective treatment for relieving many sinus problems and has no reported serious complications, it is not appropriate for everyone. Balloon sinuplasty cannot be performed on patients who have extensive scarring of the sinuses, ethmoid sinusitis or nasal polyps.

  Link: Balloon Sinuplasty

• Allergy Testing

  Allergies are an immune system reaction to a normally harmless substance. Allergy testing involves having a skin or blood test in order to determine what substance, or allergen, is triggering this allergic response. Usually, allergy testing is conducted through skin tests, which are generally considered more reliable than blood tests, though either type of test may be used. By identifying a specific allergen, an allergy sufferer can avoid them as much as possible to reduce the frequency of reactions. During a skin test, a tiny drop of a solution that contains the possible allergen is placed on the skin, which is then scratched or pricked so that the allergen enters the body. Blood tests screen for antibodies produced in response to allergens. The most common blood test is the enzyme-linked immunosorbent assay, or ELISA, which measures the amount of immunoglobulin E in the blood. Although blood tests can detect a wide range of allergies, including those that may not even produce symptoms, they are less sensitive than other tests. Reasons For Allergy Testing If an individual is experiencing typical allergic symptoms, such as sneezing, a runny nose or itchy eyes, testing may be recommended. Although the reasons allergies develop are unknown, there are some substances that are more likely to cause an allergic reaction, including pet dander, certain plants or foods and medications including penicillin. Allergy testing is performed to determine if there is a specific substance causing allergic reactions to flare. Allergy testing may be recommended if the patient has any of the following: Hives Nasal congestion Rashes Swelling or redness on the skin Watery or itchy eyes Angiodema, a type of swelling that affects deeper layers within the skin, usually around the eyes Hay fever, also known as allergic rhinitis, which causes cold-like symptoms including runny nose and congestion Types Of Allergy Testing There are two main types of allergy testing: skin tests and blood tests. Allergy skin tests expose the patient to small amounts of potential irritants such as pollen, insect venom or animal dander. They are administered in three basic ways: scratch, intradermal or patch tests. Scratch tests are administered on the forearm, with a drop of each potential allergen applied to a specific spot. Allergy skin tests are used to detect 29 common allergens. Intradermal tests differ from scratch tests since the potential allergen is inject0ed just below the skin, and they are typically only used to test for one particular substance suspected of causing an allergic reaction. Patch tests are conducted with a patch taped to the skin of the upper back for about 48 hours to test for potential reactions. Allergy blood tests detect and measure the amount of antibodies in the blood that are produced after exposure to an allergen. Whenever a person comes into contact with a substance that may trigger an allergic reaction, the body will produce antibodies against those allergens. The most common form of allergy blood tests is the enzyme-linked immunosorbent assay, or ELISA, which measures the precise amount of the antibody immunoglobulin E in the blood. Unlike allergy skin tests, which provide immediate results, results of an allergy blood test may take several weeks to be processed. Results Of Allergy Testing Negative results of allergy testing mean that there were no skin changes in response to the allergen, indicating that the patient is not allergic to a specific substance. Although rare, some patients may have a negative allergy test and still be allergic to the substance in question. When allergy testing yields a positive result, it means that the patient has experienced a reaction to a specific allergen. Usually, the patient develops a red, swollen mark on the arm, known as a wheel. Positive results of allergy testing typically suggest that any symptoms the patient has been experiencing are due to repeated exposure to the allergen. In general, skin tests deliver more accurate results than blood tests. Considerations Of Allergy Testing Allergy testing is extremely effective for identifying substances that may be causing an allergic reaction. Once allergy testing has identified an allergen, a doctor may recommend certain lifestyle changes to avoid exposure to that specific substance. Patients with allergies may also need to carry medications with them in case they do come into contact with the allergen. While it may not always be possible to prevent an allergic reaction, taking preventative measures may help prevent a serious allergic reaction in the future.

  Link: Allergy Testing

• Hoarseness

  Hoarseness refers to abnormal changes in the voice. When a person’s voice becomes hoarse, it may sound raspy, scratchy or husky. Hoarseness is usually caused by a swelling of the vocal cords, which are part of the voice box, or larynx, in the throat. Hoarseness may occur in anyone, including children. Hoarseness is generally a symptom of an underlying condition and not actually a disease itself. Fortunately, hoarseness does not usually last long, nor is it typically a sign of a serious condition. Most cases of hoarseness can be treated at home. However, if hoarseness lasts for longer than two weeks, it may be necessary to visit a doctor since persistent hoarseness is sometimes considered a warning sign of throat or laryngeal cancer. Symptoms Of Hoarseness Hoarseness is usually characterized by the voice developing a raspy, weakened or harsh quality, as well as noticeable changes to the pitch or volume of the voice. In very young children, hoarseness is often accompanied by drooling. Because hoarseness is considered a symptom of another condition, patients may need to undergo an examination to determine what exactly is causing the hoarseness. Causes Of Hoarseness Hoarseness may result when the vocal cords have become infected or develop inflammation as they tend to swell. Hoarseness most commonly occurs following a cold or sinus infection. Some of the most common causes of hoarseness include: Allergies Heavy smoking or drinking, especially the two in combination Thyroid problems, including an underactive thyroid gland Exposure to second-hand smoke Lung or throat cancer Inhalation of an irritating substance Chronic coughing Gastroesophageal reflux (GERD) Upper respiratory infection Overuse of the voice, as in shouting or singing Injury or irritation from a breathing tube, or bronchoscope Damage to the nerves or muscles around the larynx Presence of a foreign object or substance in the esophagus or trachea Ingesting a harmful or irritating substance Benign growths, or polyps, on the vocal cords Diagnosis Of Hoarseness Patients who are experiencing hoarseness may need to consult a doctor if the condition lasts for longer than 2 weeks. It is usually recommended that a patient consult an otolaryngologist, a doctor who specializes in diagnosing and managing diseases of the ears, nose, throat, mouth and sinuses. An otolaryngologist has specialty training that helps to determine the reason behind a patient’s hoarseness, as well as rule out other potential causes of the condition. A physical examination and review of the patient’s medical history will be conducted to evaluate the condition and discover the cause of the hoarseness. The examination focuses on the head and the neck and may include such tests as a throat culture, laryngoscopy or X-rays. During the examination, a direct visualization of the vocal cords will take place. Treatment For Hoarseness In most cases, hoarseness is only temporary and may be treated with at-home care. Further treatment may be necessary for patients who have longer-term cases of hoarseness. Usually, the methods of treatment will depend on the underlying cause of the hoarseness. Treatments may include Using a vaporizer to keep the airways moist Resting the voice Speaking only when needed Avoiding actions that place extra strain on the vocal cords such as singing, shouting, whispering or crying Drinking plenty of fluids Refraining from cigarette smoking and limiting exposure to second-hand smoke Medication If growths or polyps are discovered on a patient’s vocal cords, surgery may be necessary to remove them. Additionally, if the presence of lung or throat cancer is detected, further treatment will be required. Prevention Of Hoarseness There are many ways to prevent mild cases of hoarseness, including: Hydrating the body by drinking eight glasses of water and other fluids each day Avoiding beverages that dehydrate the body, such as those containing caffeine or alcohol Quitting smoking and avoiding exposure to second-hand smoke Maintaining a healthy diet and avoiding spicy foods Attempting not to overuse the voice or place strain on the vocal cords

  Link: Hoarseness

• Dizziness

  Dizziness typically encompasses the sensation of being lightheaded and possibly ready to pass out. You may also experience a vertigo-like feeling of spinning. Often the cause of dizziness is related to an abrupt decrease in blood pressure, dehydration or rising too quickly from a prone position. Much less commonly, dizziness may be the result of a serious health problem such as stroke, heart disease, internal bleeding or shock. Typically, however, there will be other accompanying symptoms if one of these issues is the cause. If that is the case, or you find your dizziness is worsening, contact your doctor’s office.

  Link: Dizziness

• Hearing Loss

  Hearing loss is the sudden or gradual decrease in how well an individual can hear sounds. Hearing loss can be mild or severe, reversible, temporary or permanent, and may affect one or both ears. Causes Of Hearing Loss The most common cause of hearing loss is age, affecting up to 25 percent of people between the ages of 65 and 75 and up to 75 percent of those over the age of 75. Age-related hearing loss, known as presbycusis, results from changes in the ear which cause gradual hearing loss. Some individuals are hearing-impaired or deaf as a result of a congenital defect or because of an illness, such as Ménière’s disease. Temporary or permanent hearing loss in people of all ages is often caused by one of the following: Loud noises, such as loud music or machinery Wax buildup in one or both ears Perforation of the eardrum from illness or injury Damage to the tiny bones, or ossicles, of the ear Fluid buildup due to ear infection Foreign object stuck in the ear canal Ototoxic medication Damage to the tiny bones, or ossicles, of the ear Types Of Hearing Loss There are three basic types of hearing loss, varying both in causes and treatment. Conductive In conductive hearing loss, the problem results from a structural or blockage problem with the outer or middle ear. This variety of hearing loss, which causes sounds to be less audible, is most often treated with surgery. Sensorineural In sensorineural hearing loss, the difficulty results from damage to the inner ear or to the auditory nerve, most commonly because the hair cells are not functioning properly. Sensorineural hearing loss, which causes sounds to be less intelligible, is often treated successfully with hearing aids. Mixed Hearing Loss Mixed hearing loss occurs when the patient suffers from hearing loss as a result of both neural and conductive malfunctions affecting both the both the outer or middle and the inner ear. Mixed hearing loss is most often treated with bone-anchored hearing aids. Symptoms Of Hearing Loss While hearing loss may affect social interaction and other aspects of daily life, people are often unaware that they have a loss of hearing until others point it out to them. Common symptoms of hearing loss may include: Muffled or unusually loud speech Inability to understand or decipher conversation Sensation that one or both ears are plugged Tinnitus, or ringing in the ears Need for increased volume on radio or television Diagnosis Of Hearing Loss In order to diagnose a possible hearing loss, the otologist or audiologist may perform various hearing tests. The most common hearing tests are: Tuning Fork Tests These tests can help to diagnose whether the vibrating parts of the middle ear, including the eardrum, are working properly and whether there is damage to the sensors or nerves of the inner ear. Audiometer Tests These tests are more thorough than tuning fork tests. During audiometer tests, the patient wears earphones and a range of sounds at various tones is directed into each ear, one at a time. As the physician plays the sounds more and more faintly, and the patient indicates when a sound is audible, the doctor is able to determine the limits of the individual’s hearing. Treatment Of Hearing Loss Treatment of hearing loss depends in the cause of the problem. For temporary loss of hearing due to wax buildup, a thorough cleaning of the ear canal, also known as an irrigation or lavage, may be helpful. For hearing loss resulting from an ear infection, antibiotics and decongestants may do the trick. For more permanent types of hearing loss resulting from aging, hearing aids may be helpful, although adjusting to them may take a few weeks. Since hearing aids work by amplifying sound, however, they will not work in all situations. If the hearing loss involves hearing static interference, for example, the patient will not be helped by simply increasing the volume. When the eardrum has been torn or perforated, surgical intervention may be necessary in the form of a tympanoplasty. More profound hearing loss as a result of congenital defect, injury or disease may necessitate the surgical implantation of cochlear implants to repair parts of the ear. Individuals coping with severe hearing loss may also learn to pay careful attention to gestures and facial expressions, to read lips, or to use sign language in order to improve their communication skills.

  Link: Hearing Loss

• Sore Throat

  Sore throat is an uncomfortable condition that often causes pain upon swallowing. Sore throats are usually the result of either viral infections, such as the common cold and flu, or bacterial infections, such as strep throat. In other cases, allergies, irritants such as chemicals or smoke, or very dry air may be responsible. Most sore throats will resolve within a few days with adequate rest, fluids and use of over-the-counter pain relievers as needed. If strep throat is the cause, antibiotics are necessary. You should visit your doctor if a sore throat lasts longer than a week, you have difficulty breathing, have a fever of 100.5 degrees F or higher, develop a rash or exhibit symptoms of dehydration.

  Link: Sore Throat

• Snoring

  Snoring is the sound created by vibrations of the soft palate when breathing is partially obstructed during sleep. While very common, occurring occasionally in about half of all adults, snoring may sometimes indicate a serious health problem. In addition, the condition can be irritating to sleep partners and result in relationship tensions. Men are more likely to snore than women and snoring is more common among older people and those who are overweight. Causes Of Snoring When a person sleeps, throat muscles relax and vibrate as air passes through blocked passages. Snoring can be brought on by a number of conditions: Chronic nasal congestion Alcohol consumption Smoking Sleep apnea Tonsillitis or adenoiditis Mouth and jaw abnormalities Airway constriction due to obesity Symptoms Of Snoring Often a person is not aware of snoring until someone else brings it up. Snoring may disrupt proper sleep patterns for the patient and the sleep partner. Heavy snorers may suffer from sleep apnea, a condition when snoring is frequently interrupted by periods of completely obstructed breathing. These periods without respiration may be dangerous. Diagnosis Of Snoring It is important to diagnose whether snoring is an isolated problem or is related to another medical condition. Snorers who also suffer from obstructive sleep apnea, for example, are more likely to have an elevated risk of high blood pressure and heart attack. In diagnosing snoring, a comprehensive medical history is taken and a full physical examination is performed. The neck circumference is measured and imaging tests are often administered in order to measure the width of oral and nasal passages and to detect any abnormalities. If sleep apnea is suspected, a sleep study is performed. Treatment Of Snoring For those with snoring issues, there are several treatment options available, ranging from home remedies to surgical intervention. Home Remedies Simple changes in lifestyle, combined with over-the-counter medications, may be sufficient to alleviate minor cases of snoring. These include: Losing weight Giving up smoking Not sleeping on the back Nasal dilators, or nasal strips Decongestant medication Prescriptions, Injections, Medical Devices In more serious cases, where snoring interferes with normal breathing during sleep, prescriptions, medical interventions, or the use of corrective mechanical devices may be indicated. Nasal Corticosteroid Sprays These medications correct snoring by reducing inflammation in the nose and relieving congestion. They must be prescribed by the doctor. Corrective Mouthpieces Custom corrective mouthpieces are form-fitting dental appliances that help to improve airflow by realigning the position of the jaw and tongue. These bite plates are fitted by a dentist and require maintenance visits to check the fit and monitor the condition. Continuous Positive Airway Pressure Continuous positive airway pressure, or CPAP, involves the patient wearing a pressurized mask over their nose while asleep. The mask pumps air through the airway to keep the breathing passage open.

  Link: Snoring

• Ear Infection

  Ear infections, also known as otitis media, are one of the most common childhood medical problems. Ear infections are the most frequent cause of doctor visits for children. In fact, three out of four children in the United States will have at least one ear infection by the time they reach the age of three. Causes Of Ear Infections While ear infections can occur in any of the three parts of the ear, they most commonly develop in the middle ear. Ear infections are caused when fluid builds up behind the eardrum in the Eustachian tubes, the tubes that connect the ears to the nose. This moist environment is conducive to the rapid growth of bacteria which result in the infection. Occasionally, although ear infections are usually caused by bacteria, viruses or allergies may be the underlying factor. Since children’s Eustachian tubes are narrower and shorter than those of adults, children are more likely to develop ear infections. In fact, ear infections are relatively rare in adults. Risk Factors For Ear Infections Certain individuals are predisposed to ear infections by heredity or anatomy. Feeding position can also be a risk factor as babies who are bottle-fed tend to develop more ear infections than breastfed babies. Children in group child care may be more likely to develop ear infections simply because they are exposed to more children who may be sick. Children exposed to secondhand smoke are also more likely to develop ear infections, as are children with weakened immune systems or allergies or those who use a pacifier.

  Link: Ear Infection

• ClariFix® Cryotherapy

  Do you suffer from frequent runny nose, congestion and post-nasal drip even when you aren’t sick? You may have a condition called chronic rhinitis. Dr. Shaari offers a unique treatment solution for adults with these frustrating chronic rhinitis symptoms. Using the patented ClariFix® cryotherapy device, we are able to go to the source of the problem, the inflamed nasal lining and out of balance nerves in the nose. The ClariFix® solution is the first and only FDA cleared device for adults with chronic rhinitis. ClariFix® cryotherapy goes to the root of the problem – the inflamed nasal lining and the underlying nerves – for lasting symptom relief. Woman relaxing breathing fresh air on the beach The device delivers freezing cold temperatures to the overactive nerves in the back of the nose, interrupting the signals and stopping the source of runny, stuffy nose symptoms. A clinical study demonstrated a significant decrease in runny nose & congestion symptoms with 4 out of 5 patients reporting long-lasting relief after ClariFix® cryotherapy.1,2

  Link: ClariFix® Cryotherapy